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Ergnomics Seminar presentation.

  1. Ergonomics. Ergonomics: The role of physiotherapy in the workplace. BY Iwuagwu Chukwunyere. 1
  2. Outline. Definition of ergonomics. Significance of ergonomics. Implications of poor ergonomics. Signs MSD. Symptoms of MSD. What are MSDs’?. Preventions of MSD. 2
  3. Outline condt. Predisposing risk factors for MSD. Reducing risk factors for MSD. Environmental conditions. Preventions. Summary. Slips, Trips and Falls. Conclusion References. 3
  4. Definition. Ergonomics is the scientific study of human at work. Ergonomic principles adapt work to a specific person by designing tasks & tools or equipment to fit the individual to prevent injuries to the musculoskeletal system (Verhagen et al. 2006). 4
  5. Significance of ergonomics. •Reduction of work-related injuries •Increased worker productivity •Increased work quality •Reduced absenteeism •Increased morale Ergonomics provides a win-win YOU JUST FEEL BETTER! 5
  6.  An “MSD” is an illness or injury that affects one or more parts of the musculoskeletal system  Bones  Muscles  Tendons  Ligaments  Cartilage  Nerves  Blood vessels  Other common terms for “MSDs”are:  Cumulative trauma disorder (CTD’s)  Repetitive strain injures (RSI’s)  Repetitive motion injuries (RMI’s) When not diagnosed and treated these can cause inconvenience permanent pain and disability. Implications of poor ergonomics. MSD MusculoSkeletal Disorders 6
  7. Signs of MSD  Decreased range of motion  Loss of function  Deformity  Cramping  Loss of color  Decreased grip strength  Loss of balance  Swelling  Redness 7
  8. SYMPTOMS OF MSD Muscle fatigue Pain Burning Sensation. Numbness Stiffness Tingling 8
  9. What are MSD’S?  MSD’s are injuries caused by sustained exposure to stressors or repetitive motion (English et al. 1995).  They may affect muscles, tendons, ligaments, bones, blood vessels, or nerves.  Some well-known MSD’s are: Carpel tunnel syndrome Guyon’s syndrome Trigger finger Tennis elbow 9
  10. CARPAL TUNNEL SYNDROME The median nerve does not work properly due to pressure on the nerve as it runs through an opening called the carpel tunnel Numbness is usually first symptom. Pain & tingling, can go up the arm to the shoulder and neck, causing waking to pain in middle of night 10
  11. GUYON’S CANAL SYNDROME Guyon’s affects the ulnar nerve as it passes through the Guyon canal in the wrist; this is similar to carpal tunnel, but involves a different nerve (Davis et al.1998) Unlike carpel tunnel, Guyon’s affects the little and ring fingers. Can be in conjunction with carpal tunnel 11
  12. TRIGGER FINGER  Trigger finger affects the ability of tendons to slip back and forth. The tendon and/or ligament thicken and a nodule forms  This can be caused by rheumatoid arthritis, lacerations of tendon, gripping power tools, long hours of grasping steering wheel, or birth defects (Aaras 1994).  Symptoms are pain and a funny clicking sensation 12
  13. TENNIS ELBOW  Overuse or misuse of the forearm muscles can cause tendonitis, or a painful inflammation of the tendons connecting these muscles to bone (English et al. (1995).  This condition is brought on or aggravated by poor leverage causing an uneven distribution of force on a few muscles.  This may be when working, or during certain leisure activities, such as sports and gardening. Symptom are severe pain. 13
  14. ARE MSD’S PREVENTABLE?  They are preventable and reversible ….. if identified early.  The treatment depends on the stage of MSD.  If the condition cannot be reversed, treatment can turn into a pain management situation. The individual plays a large role in preventing MSD’s. 14
  15. Predisposing risk factors for MSD Do you …perform frequent repetitive motions? …bend at the waist or twist when lifting objects? …lift push or pull objects throughout the day? …sometimes use the wrong tool for the job? …grasp tools with your fingers? …forget to take breaks while working? …feel like you are under stress? …have to stretch to reach your work? …forget to adjust your work area to fit your task? The more you answered “yes”, the greater your risk. 15
  16. RISK FACTORS which can lead to MSDs (Stressors)  Awkward posture  Static loading or sustained exertion  Contact stress  Force  Vibration  Repetition of same motion for several hours/day  Length of tasks without breaks  Insufficient rest time  Psychosocial stress These STRESSORS can be influenced by 1. Organizational or administrative precautions 2. Environmental conditions 3. Individual work routine and habits Most MSDs are the result of combined risk factors 16
  17. Reducing RISK FACTORS for MSDs  The purpose of ergonomic training is to help you reduce or eliminate the stresses that can lead to MSDs (Schierhout et al. 1991).  Your body is designed to do work. When it works in positions or postures in which it is designed to deal with physical stress, there is no problem, but when it is forced to perform under unnatural situations or for abnormal periods of time, injuries can occur.  Almost all of the ergonomic stresses at work can be decreased by using the right equipment in the right position so that the body can perform in the right posture. 17
  18. Review your Work Area •You spend most of your day in your work area. •You don’t want your work area to contribute to ergonomic problems •Ergonomic Rule #1 Work Comfortably!
  19. Use a good CHAIR (adapted from Ando et al 2004) Front edge of seat pan curves down Five feet for base-most stable Height adjustable On rollers Seat pan adjustable horizontally and tilts Backrest provides good lower back support Arms adjustable 19
  20.  The position of your head and neck is very important  Place computer monitors directly in front of you  The right height is person dependent- usually the top of the screen at eye level (or slightly below for those who wear bifocals)  The screen should be at least an arms length away (If you can’t see at that distance, get special computer glasses) MONITOR HEIGHT Raise the monitor if you have to look down at it 20
  21. KEYBOARD STYLES A variety of styles are available. Choose one that is comfortable for you. 21
  22. KEYBOARD HOLDER Keyboard holders should  Tilt  Provide wrist rests (rest palms not wrist)  Provide space for a mouse 22
  23. MOUSE HOLDERS Mouse trays or mouse holders can bring a mouse to a better position 23
  24. MOUSE STYLES Choose a style comfortable for your hand and fingers 24
  25. WORK PLACEMENT  Position equipment so that your body is in a comfortable and natural position most of the time while you are working.  Don’t place things so you have to reach, twist or bend continually  Place work at monitor height or place in path of monitor  Listen to your body. If you cannot focus or often feel tired or uncomfortable, you are probably not working in a good position.  See what you can do to make your work more comfortable for you. Disclaimer: Wait a minute! Though this position may look comfortable, it is NOT a comfortable position to work in. Imagine how your back would feel after typing a few pages in this position! Do not equate comfortable leisure positions with comfortable work positions! 25
  26. Everyone needs a relaxed, neutral position DO WHAT’S COMFORTABLE FOR YOUR BODY! Monitor at or below eye level Wrists straight Forearms supported Back supported Feet flat on the floor Forearms and thighs parallel to the floor 26
  27. MOUSE POSITION NO!  Mouse should be close to the keyboard and the same height or slightly higher  Locate the mouse to avoid reaching 27
  28. Phone PLACEMENT Should be different for right and left handers You should not have to twist and reach across your body every time you answer the phone. Many people need to spend a lot of time on the phone, and must often do other tasks at the same time This creates a lot of stress for neck and shoulder muscles Consider a head set if you spend a lot of time on the phone, especially if you do other tasks at the same time 28
  29. Document PLACEMENT Place documents so that you don’t need to bend your head to read while you keyboard Consider getting a document holder 29
  30. Ergonomic STRESSORS Environmental conditions Environmental conditions can influence ergonomic stress (Westlander et al. 1998). Lighting Noise Temperature ….even at a computer station! 30
  31. LIGHTING & MONITOR GLARE  Lighting should be indirect and adequate  Not too much light, or it may cause a glare, headaches and eye fatigue  If there is a glare on your eyes as you work, use glare screens on computers, or adjustable blinds at windows Ideal is 35-50 foot candles Ergonomic STRESSORS 31
  33. Noise can be a STRESSOR If your office is near a noise source, close your door, or wear ear plugs Besides causing ear damage, constant noise can create extra muscle tension in the body causing fatigue and making it easier for ergonomic injuries to occur (Westlander et al 1998). Ergonomic STRESSORS 33
  34. Temperature  People are more prone to ergonomic injuries in cold environments. Muscles and other tissues are more tense, because of decreased circulation (Schierhout et al 1995)..  Dress appropriately  Do some warm up exercises, such as stretching your hands, to loosen your finger muscles before keyboarding. Ergonomic STRESSORS 34
  35. MECHANICAL CONTACT STRESS A hard or sharp surface or object pressing into the soft tissues, the tendons, nerves and blood vessels. Examples:  Resting wrists on the desk edge while typing or using mouse  Leaning elbows on hard chair or armrests or work surfaces  Sitting in chair that places pressure on the backs of the thighs Ergonomic STRESSORS 35
  36. VIBRATION causes stress Hand-arm vibration (hand power tools) Whole body vibration (driving rough off roads) Even if these do not occur in your work environment, what about home activities? Ergonomic STRESSORS 36
  37. HOME-OFFICE CONNECTION  What happens off the job may influence stress, discomfort, or pain during the workday and vise-versa.The two are intertwined.  Hobbies and recreational activities (golf, sewing, gardening, etc.) may cause repetitive motion injuries, which may then be complicated on the job. Ergonomic STRESSORS 37
  38. Psycosocial Stress Any interactions, job tasks or personal problems which cause psychological or social stress cause increased muscle tension, which can make injury more likely. Be aware of these additional stresses and compensate for them by taking extra breaks and being especially careful when under extra pressure (Benard et al 1994). Ergonomic STRESSORS 38
  39. INDIVIDUAL STRESSORS People face different stresses and have different abilities to cope. Employees vary in physical condition. Some individuals are also dealing with chronic illnesses or disabilities We don’t live in a vacuum, life stresses can adversely effect the wellness of an individual and contribute to ergonomic stressors. Ergonomic STRESSORS 39
  40. Individual work routine and habit Fortunately, most STRESSORS can be minimized or eliminated by individual habits and work routine. The solution to most ergonomic problems is to work comfortably and avoid a few common ergonomic pitfalls. Prevention of workplace injuries 40
  41. Avoid REPETITION Performing the same or similar motions repeatedly for extended periods without time for rest and recovery can lead to discomfort or trauma (English et al. 1995). Examples:  Keyboarding, mousing.  Flipping through files & paperwork  Extended reading or writing  Punching or stapling  Pruning or clipping  Painting  Hammering Solutions 41
  42. AVOID LONG DURATION OF SAME TASK  The length of time spent on a task without breaks, shifts in position, or stretches is more important than the actual task.  The longer the uninterrupted duration of a task, the more potential for discomfort or injury Our bodies are designed to do work. But the result on the body of doing a repetitive task for 2 hours verses 6 hours straight is very different. Solutions 42
  43. STRETCHES & BREAKS Solutions Static positions are your enemy! Whenever you think of it, change position Small frequent stretches go a long way in preventing MSD’s. 43
  44. Stretch Break  Stretch Break (default), is a software that interrupts you every 30 minutes- suggests three varied stretches which take a total of 1 minute to complete. You cannot believe how much better you feel afterwards (Van den Heuvel et al 2003).  You can cancel the stretches as soon as they come on the screen, choose the amount of time you work before being interrupted ( between 10 minutes and 3 hours) and decide which of the many exercises you want to include, and how many you want to do at each break.  Such programs are one of the best preventions of ergonomic injuries at a computer workstation. Even if you choose not to do the exercises, you will be reminded to shift position, etc periodically so that your muscles do not become unduly stressed. Most computer related injuries occur because of projects which engage persons for a substantial length of time. 44
  45. A FEW BREAK IDEAS  Organize tasks around built in breaks  Eye breaks - blink to moisten eyes every 5-10 minutes. Every 15 minutes or so look away from the screen to distant part of room.  Micro-breaks - between burst of activity rest the hands, neck and shoulders in a relaxed straight posture.  Rest breaks - every 30-60 minutes take a brief 5-minute break and engage in another activity.  Exercise breaks - every 1-2 hours do gentle stretching exercises Solutions 45
  46. EXERCISES & STRETCHES These are exercises or stretches that can be performed at your workstation, home, just about anywhere. 46
  47. EYE Eye comfort exercises Blinking Yawning Focus change 47
  48. EYE Palming While seated, brace elbows on the edge of the desk Let weight fall forward Cup hands over eyes and close eyes Inhale slowly through nose & hold for 4 seconds Continue deep breathing for 15-30 seconds 48
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  50. EYE Movements Close eyes and slowly & gently move eyes up to the ceiling, then slowly down to the floor Repeat 3 times Close eyes and slowly & gently move eyes to the left, then slowly to the right Repeat 3 times 50
  51. NECK STRETCH Tilt ear towards shoulder Reach up and touch top of head with palm to hold in tilted position Hold 5-10 seconds. Repeat 2-3 times (come out of stretch slowly) Reverse side and repeat 51
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  53. Pec Corner Stretch  Stand at a corner about a foot away from the wall with forearms on opposite sides of the corner. One foot should be forward.  Elbows should be at slightly below shoulder height  Keep abdominals tight to avoid arching back  Lean gently towards corner by bending the front knee until a stretch is felt in front of the chest.  Hold 5-10 seconds. Repeat 2-3 times 53
  54. Overhead Reach Take a deep breathe and reach up over head with both arms. Hold 5-10 seconds Exhale and lower slowly Repeat 2-3 times 54
  55. Shoulder Pinch Place arms behind head being careful not to press hand into head Relax shoulders, and squeeze shoulder blades together while keeping shoulders back and down Hold 5-10 seconds. Repeat 2-3 times 55
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  57. Shoulder Shrug Sitting up straight, slowly bring shoulders up toward your ears. Hold positions 5-10 seconds Then bring the shoulders down and hold Repeat 2-3 times 57
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  59. Chair Rotation Stretch Sit in chair and place feet flat on floor Reach across your body and grab the back of the chair Pull gently to increase stretch in mid back Hold 5-10 seconds. Repeat 5 times Repeat on other side 59
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  61. Arms Behind Back Stretch Hold hands behind back and grasp hands together Pull shoulder blades back and down Hold 5 seconds. Repeat 5 times 61
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  63. Thoracic Spine Extension Stretch Lie on your back with a pillow under your knees. Place a firmly rolled towel under your shoulder blades across your upper back Raise arms up as you inhale Lower arms as you exhale, and hold a couple of seconds Do this 5 times 63
  64. Prop Ups or Press Ups  Lie on stomach and either prop up on forearms or if wrists are not compromised, press up through hands.  Let stomach sag, and allow back to arch without using back muscles.  If propped on elbows, hold 5-10 seconds. Repeat 5 times  If on hands, press up and down slowly 10 times 64
  65. Foot Rotations While sitting upright, slowly rotate each foot from the ankles 3 times in one direction Then rotate 3 in the opposite direction 65
  66. Wrist Flexed & Extended  Hold arm straight at waist height  With fingers of other hand, gently press down above the knuckles, bending wrist down. (DO NOT hold at the fingers to push down.)  Hold 5-10 seconds and repeat 2-3 times  For extending, hold onto palm of hand and stretch wrist back. (DO NOT pull on fingers.)  Hold 5-10 seconds and repeat 2-3 times. 66
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  69. Finger Massage VERY gently, massage the fingers of each hand individually. Move toward the nail gently. Massage the space between your fingers to widen and relax 69
  70. Finger Squeeze Squeeze a foam block OR the edge of your desk firmly with all fingers Hold for 3 seconds Relax your grip 70
  71. Avoid BAD POSTURES Bad postures are a primary cause of ergonomic injuries Everyone has seen these…. Propping a phone on shoulder Slouching over a computer Solutions 71
  72. Avoid AWKARD POSITIONS Awkward positions bend the joints in a way that they are more likely to become injured. Examples:  Reaching up and over  Slouching or leaning forward in the chair  Leaning forward or bending over work  Holding heavy items in position  Lifting, pushing pulling  Turning head side to side to view the monitor  Cradling the phone between the ear and shoulder  Typing with bent wrists AWKWARD POSITIONScreateSTRESS Solutions 72
  73. Avoid SUSTAINED EXERTIONS Static loading occurs when muscles must hold the body in a single position for a long period of time. Lack of movement reduces circulation and causes muscle tension Examples:  Holding hands in place  Keeping the head still while reading  Sitting still for long periods of time  Sitting upright without back support STATIC POSITIONScreateSTRESS Solutions 73
  74. Lifting (Static Loading) A large percentage of ergonomic injuries are due to improper lifting. Planning the lift before attempting it will prevent most injuries (Ando et al. 2004). Solutions When evaluating a lifting task, consider: 1. The weight of the object 2. What position it must be lifted from and to 3. How many times you will need to lift it 4. If there will be twisting involved 5. If there is good footing, and if you can get a good grasp on the object 74
  75. Lifting (Static Loading)  Use a step stool or platform to reach loads above your head  For bulky and oversized loads, get help or use mechanical aids  Get a good grip- use handles when available Solutions 75
  76. Lifting (Static Loading)  Don’t pull  Push  Get twice the power  Reduce the risk of injury Solutions 76
  77. Lifting (Static Loading)  Get a firm grip on what you are lifting and be sure you are on solid footing  Squat when lifting something from below the waist. Keep heels down and feet shoulder-width apart and turned out  Keep the load close to your body  Turn your whole body in the direction you want to move- avoid twisting when lifting  Keep your knees bent and lean in the direction of the movement  Let your legs and body weight do the work  Squat to set loads down Solutions 77
  78. NO ONE SOLUTION FOR ALL  People come in all shapes and sizes- what works for one person may or may not work for another.  Ergonomics is a puzzle to be put together for each individual.  What works today may or may not work later. We all change due to time and other circumstances. Individualize Solutions 78
  79. ergonomic risk assessment. Identify types of ergonomic problems  Look at your daily work tasks  Identify one or more risk factors  Review & rethink your work activities/tasks (including those outside of work). 79
  80. Identify barriers to solving the problems  Discuss concerns and possible solutions with your supervisor  Adjusting work schedules  Modifying job design  Rearranging task order  Changing task assignments  Consult a Physiotherapist, physician or occupational therapist if warranted. 80
  81. Identify approaches to overcoming the barriers  Recommend and/or implement solutions.  Try something and if it doesn’t feel comfortable, discontinue and try something else!  As time passes, try to notice if the problem has truly been eliminated.  Let your supervisor know how well the controls are working. 81
  82. You Can Reduce Risk Greatly Improve body posture and keep a safe body position • avoid awkward positions • use tools and equipment correctly Rearrange work area- •control your environment, •use the right equipment in the right position, •keep work within reach Change work habits- •practice and use correct procedures, •avoid repetition and long duration of a single task •take frequent breaks Apply ergonomic principals at home, too Summary 82
  83. SLIPS TRIPS FALLS Real slips, trips and falls are not funny. people are injured and work time is lost by slips, trips, and falls. 83
  84. Slips, Trips and Falls •Hazards that can lead to slips, trips and falls are often overlooked, even though they cause many injuries ranging from minor cuts and sprains to disabling injuries and even death (Aaras 1994, Ando et al 2004). •Although slip, trip and fall hazards are easily created, they are also easy to correct. •Be aware of such hazards, and correct them quickly, before the next person becomes a victim! 84
  85. SLIP Hazards A slip occurs when there is too little friction or traction between footwear and a walking surface. Common causes of slips are: •Slippery floor surfaces •Liquid, moisture or ice on the floor, •Food, trash or other small objects •Oil or grease on the floor •Footwear without nonskid soles 85
  86. Trip Hazards A trip occurs when a person’s foot contacts an object or drops to a lower level unexpectedly, and they are thrown off balance. Some common causes of tripping are: Desk or file cabinet drawers left open, objects protruding into passageways and aisles Electrical or telephone cords that cross passageways and aisles Insufficient lighting for walking or working areas Furniture that creates obstacles Hazardous floor conditions such as protruding nails, holes or loose boards, loose carpet and rugs Elevator cars that do not level off at the same height of the floor stopped at Unsafe stairway conditions or use Materials stored in passageways, aisles and stairways Floor level changes or hidden steps that may not be obvious 86
  87. Fall Hazards In addition to falls as a result of slips and trips, you may be injured if you fall from an elevation. Some causes of falls are: •Using makeshift items (boxes, buckets, chairs, etc ) to gain height •Not sitting on “4 square” of a chair •Carrying large or too many items that prevents seeing where you are going •Jumping from one level to another 87
  88. In Conclusion… •Take responsibility for the safety of your work area. •Report unsafe situations or conditions to your supervisors. • Think Safety Act Safely 88
  89. References.  Verhagen A. et al. (2006). Ergonomic and physiotherapeutic interventions for treating work- related complaints of the arm neck or shoulder in adults. The cochrane Library (3)  Ando, S. et al. (2004). Association of self esitmated workloads with musculoskeletal symptoms among hospital nurses’. Occupational andEnvironmental Medicine, 57(3):21-16.  Bernard, B. et al. (1994) ‘Job task and psychosocial risk factors for work-related musculoskeletal disorders among the newspaper employees’. Scandinavian Journal of Work, Environment and Health, 20(6):417- 426.  English, C. et al. (1995) ‘Relations between upper limb and soft tissue disorders and repetitive movement at work’. American Industrial Hygiene Association Journal, 27(1):175- 90.  Van den Heuvel et al. (2003). Effects of software programs stimulating regular breaks and exercises on work-related neck and upper limb disorders. Scand J of Work, Environment and Health 29(2) pg 106-116.  Viljanen et al. (2003). Effectiveness of dynamic muscle training relaxation training or ordinary activity for chronic neck pain: Randomised Control Trial. BMJ 327(413) pg. 475.  Schierhout G H, Meyers J E, Bridgers R S (1995) Work related musculoskeletal disorders and ergonomic stressors in the South African Workforce. Occupational and Environmental Medicine. 52(1): 46-50.  Aaras A. (1994). The impact of ergonomic intervention on individual health and corporate prosperity in a telecommunications environment. Ergonomics . 37 (10):1679–96. 89
  90. References Condt.  Carlton R. (1987). The effects of body mechanics instruction on work performance. American Journal of Occupational Therapy. 41(1):16–20.  Davis P. et al. (1998). Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trial. Journal of Manipulative and Physiological Therapeutics. 21(5):317–26.  Westlander G, et al. (1995). Evaluation of an ergonomics intervention programme in VDT workplaces. Applied Ergonomics. 26(2):83–92. 90

Hinweis der Redaktion

  1. Signs of MSD are objective physical findings.
  2. Symptoms can vary in their severity depending on the amount of exposure the employee has had. Often the symptoms appear gradually as muscle fatigue or pain at work that disappears during rest. Usually the symptoms become more severe as exposure continues. An example is tingling continues when the employee is at rest, numbness or pain make it difficult to perform the job, and finally the pain is so severe the employee is unable to perform physical work activities.
  3. We will give exercises & stretches for all parts of the body. Perform these at your workstation, at home, or anywhere else. There are written descriptions for each exercise and demonstrations for some of others. Get the audience to stand up and do these together.
  4. Blinking and Yawning both produce tears to help moisten and lubricate the eyes. Focus on a distance object across the room or even outside the window.
  5. Next slide shows exercise
  6. Picture of palming.
  7. Next slide shows exercise
  8. Picture of neck stretch.
  9. WHAT is “Pec” ??
  10. Next slide shows exercise
  11. Picture Shoulder Pinch
  12. Next slide shows exercise
  13. Picture shoulder shrug
  14. Next slide shows exercise
  15. Picture of chair rotation stretch
  16. Next slide shows exercise
  17. Picture of arms behind back stretch
  18. Next 2 slides show exercise
  19. Picture of flexing.
  20. Picture of extending